Conventional analog projection radiography involves projecting a beam of x-radiation through a body part of a patient and recording the projected radiographic image on unexposed film in contact with one or two screens contained in a cassette. The film is then removed from the cassette in a darkroom environment and processed using chemical processing. Cassettes can also be reloaded with unexposed radiographic film in the darkroom. The developed film is then placed on a light box for review and diagnosis by a trained health care professional, such as a radiologist. The typical analog radiography department include ID cameras for exposing patient identification and other information on exposed x-ray film, darkrooms and radiographic film processors, chemical supplies, a water source, processor QA (Quality Assurance) strips, film/screen contact tests, waste film bin, monthly repeat analysis, and dose management supported by a fixed speed system. A typical darkroom needs water, a drain for chemicals, 220V power, ventilation, a safelight, chemical supply, and a film supply.
As with consumer and professional photography, conventional analog film/screen radiography is being supplemented and/or replaced by digital radiographic systems, such as computed radiography (CR) and digital radiography (DR).
The digital radiology department is configured to include the following: CR and DR systems for radiographic image processing, high resolution workstations for reviewing digital radiographic images, test tool phantoms for system analysis. The computer based digital department includes the ability to delete images, the ability to fix images, and allows the use of auto density correction. Patient ID is managed through RIS/HIS (Radiology Information Systems/Hospital Information Systems) interface. Software is available to manage many tasks. Thus, CR and DR will replace film, QA workstations will replace QA lightboxes, barcode scanners will replace ID cameras, PACS or printers will replace processors, and pixel will replace grains of silver. However. technologists will remain the same and patients and diseases will be as usual.
Managing image quality takes a different focus in a digital world in a film environment, any exposure variation is immediately evident managers and technologists in charge of quality control monitor exposure accuracy by analyzing the bin of rejected films and talking to technologists about how to resolve any problems the goal is to reduce repeat exams to eliminate multiple radiation doses for patients while simultaneously improving departmental efficiency. In the digital world, the ability to delete mistakes meant that this valuable tool for tracking and improving the image capture process was lost. It is desirable that there be a solution that allows review of repeated exams and review of exposure levels used from a department-wide perspective, rather than from each individual system. This would give quality managers a convenient snapshot of how individuals are doing. For example, if a student has been working to improve his lateral C-spine images, the manager or educator could view this technologist's repeat analysis results, regardless of which radiographic system was used to make the images.
There is a need in the digital radiology department for administrative analysis and reporting to measure, track and manage performance of people, processes, and devices. There is also a need to manage quality such as, over and under x-ray exposure, x-ray image repeats, and imaging system performance.